小儿心痛，当于大人心痛门参用之。
心痛吐水者，虫痛。心痛不吐水者，冷心痛。
钱氏灵矾散 治小儿虫咬心痛，欲绝。
五灵脂（二钱） 白矾（火飞，半钱）
上，同研。每服一二钱，水一钟，煎至五分，温服，无时。当吐出虫。
《圣惠》治小儿心痛，但觉儿将手数数摩心腹即啼，是心痛不可忍，宜服。芍药散方
赤芍药 人参（去芦） 白术 黄芩 川大黄（微炒，锉） 当归（以上各一分）
上，捣罗为粗散。每服一钱，以水一小盏，煎至五分，去滓，不计时候，量儿
大小加减，温服。
〔茅先生〕治小儿心痛。金铃散
金铃子（炮，去皮核） 蓬莪术（炮、各一两） 茴香 木香（炮） 荆三棱（炮。各半两）
上为末。每服一钱半钱，用热酒、调下。
〔薛〕仲景云；火入于肺则烦，入于肾则躁。夫心者君火也，火王则金燔水亏，
而火独存，故肺肾合而为躁也。《活人》云∶但烦热者，虚烦也，诸虚烦热，与伤寒
相似，但不恶寒，身不疼，故知非伤寒也，头不痛，脉不紧，故知非里实
也。不可发汗攻下，当与竹叶汤，兼呕者与橘皮汤。又心虚则先烦而后渴，翕翕发
热，其脉浮紧而大是也。盖烦者，心中烦扰而内热，故属阳。躁者，肢体躁动、或
裸身欲入井中，为外热，故属阴。外热者，无根之火也，是以为虚。在小儿当辨其
煎不安是烦， 不定是躁。 煎者，心经有热，精神恍惚，烦满生惊。 者，
心经有风，烦躁惊搐也。热甚者，黄连解毒汤，轻者，导赤散，风热者，至宝丹，
脉数而实，便闭有热者，神芎丸，此皆实热之治法也。若烦而头痛短气，口干咽燥
不渴者，虚也，用四君加芎归。因药攻伐而作渴者，用竹茹汤。烦而不得眠者，酸
枣仁汤。心神颠倒，烦热欲吐者，朱砂安神丸。面戴阳，目内赤，六脉洪大按之全
无者，血虚发躁，用当归补血汤。若躁而裸体欲入井中，脉沉细或浮大，按之如无
者，此皆阴盛发躁也，宜用参附汤，有回生之功。
清热解毒丸 治五脏积热，毒瓦斯上攻，胸臆烦闷，咽喉肿痛，赤眼壅肿，
头面发热，唇口干燥，两颊生疮，精神恍惚，心忪闷乱，坐卧不宁。及伤暑毒面赤
身热，心烦躁而渴，饮食不下。
寒水石 石膏（各八两） 青黛（四两）
上研末，入青黛和匀，蒸饼七个水调为丸，如芡实大。每服一丸，食后，新
汲水化下，或细嚼，生姜汤下。如中诸毒，并宜服之。及惊风潮热，痰涎壅塞，
心胸烦躁，颊赤多渴，坐卧不稳，每服半粒，量大小加减。
竹茹汤（吐）
橘皮汤
橘皮（一两半） 甘草（炙） 竹茹（各半两） 人参（二钱五分）
上，每服五钱，姜水煎，食前服。
黄连解毒汤 治时疾三日，汗已解，若烦闷干呕，口燥呻吟，发热不卧。
黄连（炒，三钱） 黄柏（炒，半两） 栀子（炒，四枚） 黄芩（炒，二钱）
上，每服二三钱，水煎。未效再服。亦治热痢。
导赤散（心）
至宝丹 治诸惊痫心热，及卒中客忤、烦躁风涎搐搦，或伤寒狂语，伏热呕吐。
生犀角（镑） 生玳瑁（镑） 琥珀 朱砂（水飞） 雄黄（水飞。各一两） 金箔（五十片，
一半为衣） 银箔（五十片） 片脑（一匙） 麝香（一钱） 牛黄（半两） 安息香（一
两半，为末，酒掬去砂，取一两，酒煎成膏）
上各另研为末，和匀，入安息香膏，如干，入熟蜜少许，丸桐子大。每服一二
丸，人参汤化下。量儿加减用之。
神芎丸 治风热壅滞，头目昏眩，口舌生疮，牙齿疳蚀，或遍身疮疥切牙，惊惕怔
忡，烦躁作渴，或大便涩滞，或积热腹满，惊风潮搐等证。
大黄（生） 黄芩（各二两） 生牵牛末（一两） 滑石（四两） 黄连 薄荷叶 川
芎（各半两）
上为末，水糊丸，如桐子大。每服三四丸，温水下。
酸枣仁汤
酸枣仁（去壳取仁） 甘草（炙） 生地黄 栀子仁 麦门冬 人参 当归身（各等分）
上锉细。加灯心，水一盏，煎七分，去滓温服，不拘时。
朱砂安神丸（心） 当归补血汤（虚热）
心痛且伴有呕吐清水的，是虫痛（寄生虫引起的疼痛）。心痛且不呕吐清水的，是冷心痛（寒邪所致的心痛）。
钱乙的灵矾散，治疗小儿因虫咬引起的心痛，疼痛剧烈近乎昏厥。
方药：五灵脂（二钱），白矾（经火煅制飞过的，半钱）。
制法与用法：将上述药物共同研磨成细粉。每次服用一二钱，加水一钟（约200毫升），煎煮至五分（约100毫升），温服，不拘时间。服药后应当吐出虫子。
《圣济总录》记载的芍药散，治疗小儿心痛，只要发现孩子频繁用手抚摸心腹部并啼哭，这是心痛难以忍受的表现，适宜服用此方。
方药：赤芍药、人参（去芦头）、白术、黄芩、川大黄（微炒，切碎）、当归（以上各一分）。
制法与用法：将上述药物捣碎并过筛成粗散。每次服用一钱，加水一小盏（约50-100毫升），煎煮至五分，滤去药渣，不分时候，根据患儿年龄大小调整剂量，温服。
茅先生记载的金铃散，治疗小儿心痛。
方药：金铃子（炮制，去皮核）、蓬莪术（炮制，各一两）、茴香、木香（炮制）、荆三棱（炮制，各半两）。
制法与用法：将上述药物研为粉末。每次服用一钱或半钱，用热酒调服。
薛己引用张仲景的话说：“火邪侵入肺则产生烦感，侵入肾则产生躁动。”心属于君火，当火气旺盛时，会导致肺金被灼烧、肾水亏损，而火邪独存，所以肺和肾合病表现为躁动。《伤寒六书》（即《活人书》）说：“仅有烦热感的，是虚烦。各种虚证引起的烦热，症状与伤寒相似，但不恶寒，身体不疼痛，因此知道不是伤寒；头部不痛，脉象不紧，因此知道不是里实证。不可使用发汗或攻下的方法，应当给予竹叶汤，如果兼有呕吐的，给予橘皮汤。另外，心气虚弱则先出现烦感而后口渴，伴有轻微发热，脉象浮紧而大。所谓‘烦’，是指心中烦乱扰攘且内部有热，所以归属于阳证。所谓‘躁’，是指肢体躁动不安，或者脱光身子想要跳入井中，这是外部假热，所以归属于阴证。外部的热是无根之火，因此属于虚证。在小儿身上，应当辨别其坐卧不安是‘烦’，动作不定是‘躁’。‘烦’，是因为心经有热，导致精神恍惚，心烦胸闷而生惊悸。‘躁’，是因为心经受风，导致烦躁惊厥抽搐。热势严重的，用黄连解毒汤；轻症的，用导赤散；风热证的，用至宝丹；脉象数而有力，大便闭塞且有热的，用神芎丸，这些都是治疗实热的方法。如果烦闷且头痛、短气，口干咽燥但不觉得渴的，属于虚证，用四君子汤加川芎、当归。因为药物攻伐过度而引起口渴的，用竹茹汤。烦闷且无法入睡的，用酸枣仁汤。心神错乱，烦热想吐的，用朱砂安神丸。面色泛红如戴阳，眼睛内部发红，六脉洪大但重按完全无力的，是血虚导致的躁动，用当归补血汤。如果躁动且脱光身子想要跳入井中，脉象沉细或浮大但重按如无的，这都是阴盛格阳导致的躁动，适宜用参附汤，具有回阳救逆的功效。
清热解毒丸，治疗五脏积热，毒气上攻，导致胸膈烦闷，咽喉肿痛，眼睛红肿，头面部发热，嘴唇口腔干燥，两颊生疮，精神恍惚，心悸闷乱，坐卧不宁。以及中暑毒导致面红身热，心烦躁且口渴，饮食不下。
方药：寒水石、石膏（各八两），青黛（四两）。
制法与用法：将上述药物研为粉末，加入青黛混合均匀，用七个蒸饼的水调和制成丸药，大小如芡实。每次服用一丸，饭后用新汲水化开吞服，或者细细咀嚼，用生姜汤送下。如果是中了各种毒，也都适宜服用。对于惊风潮热，痰涎壅塞，心胸烦躁，脸颊发红多渴，坐卧不稳的情况，每次服用半粒，根据年龄大小调整剂量。
橘皮汤
方药：橘皮（一两半）、甘草（炙烤）、竹茹（各半两）、人参（二钱五分）。
制法与用法：每次服用五钱，用姜水煎煮，饭前服用。
黄连解毒汤，治疗时行疫病三天后，汗出已解，但如果仍有烦闷干呕，口燥呻吟，发热不能安卧。
方药：黄连（炒，三钱）、黄柏（炒，半两）、栀子（炒，四枚）、黄芩（炒，二钱）。
制法与用法：每次服用二三钱，用水煎煮。如果无效再服用。也治疗热痢。
至宝丹，治疗各种惊痫心热，以及突然中客忤之气、烦躁风涎抽搐，或者伤寒谵语，伏热呕吐。
方药：生犀角（镑片）、生玳瑁（镑片）、琥珀、朱砂（水飞法处理）、雄黄（水飞法处理，各一两）、金箔（五十片，一半用来包衣）、银箔（五十片）、片脑（冰片，一匙）、麝香（一钱）、牛黄（半两）、安息香（一两半，研末，用酒浸泡去除沙土，取一两，用酒煎成膏状）。
制法与用法：将各药分别单独研为粉末，混合均匀，加入安息香膏，如果太干，加入少许熟蜜，制成梧桐子大小的丸药。每次服用一二丸，用人参汤化开送下。根据患儿情况调整剂量使用。
神芎丸，治疗风热壅滞，头目昏眩，口舌生疮，牙齿疳蚀，或者全身疮疥咬牙，惊惕怔忡，烦躁作渴，或者大便涩滞，或者积热腹满，惊风潮搐等证候。
方药：大黄（生用）、黄芩（各二两）、生牵牛末（一两）、滑石（四两）、黄连、薄荷叶、川芎（各半两）。
制法与用法：将上述药物研为粉末，用水糊制作丸药，大小如梧桐子。每次服用三四丸，温水送下。
酸枣仁汤
方药：酸枣仁（去壳取仁）、甘草（炙烤）、生地黄、栀子仁、麦门冬、人参、当归身（各等分）。
制法与用法：切碎。加入灯心草，加水一盏，煎煮至七分，滤去药渣，温服，不拘时间。
Pediatric heart pain should be diagnosed and treated by referring to the section on adult heart pain.
Heart pain accompanied by vomiting clear water indicates worm pain (pain caused by parasites). Heart pain without vomiting clear water indicates cold heart pain (heart pain caused by cold pathogen).
Qian Yi's Lingfan San treats pediatric heart pain caused by worm bites, where the pain is so severe it approaches syncope.
Ingredients: Wulingzhi (Trogopterus Dung, 2 qian), Baifan (Calcined Alum, 0.5 qian).
Preparation and Administration: Grind the above ingredients together into a fine powder. Take 1–2 qian per dose, add one zhong (approx. 200 ml) of water, decoct until reduced to five fen (approx. 100 ml), and take warm at any time. The patient should vomit worms after administration.
The Shaoyao San recorded in *Shengji Zonglu* treats pediatric heart pain. If the child frequently rubs the chest and abdomen with their hands and cries, indicating unbearable heart pain, this formula is suitable.
Ingredients: Chishao Yao (Red Peony Root), Renshen (Ginseng Root, rhizomes removed), Baizhu (Atractylodes Macrocephala Rhizome), Huangqin (Scutellaria Root), Chuan Dahuang (Rhubarb Radix et Rhizoma, lightly stir-fried and sliced), Danggui (Angelica Sinensis Radix) (each 1 fen).
Preparation and Administration: Pound and sieve the above ingredients into a coarse powder. Take 1 qian per dose, add one small zhan (approx. 50–100 ml) of water, decoct until reduced to five fen, strain, and take warm at any time, adjusting the dose according to the child’s age and size.
Mr. Mao’s Jinling San treats pediatric heart pain.
Ingredients: Jinlingzi (Chaenomeles Fruit, processed, skin and seeds removed), Peng Ezhu (Curcuma Zedoaria Rhizome, processed, 1 liang each), Huixiang (Fennel Fructus), Muxiang (Vladimiria Root, processed), Jing Sanleng (Sparganium Rhizome, processed, 0.5 liang each).
Preparation and Administration: Grind the above ingredients into powder. Take 1 or 0.5 qian per dose, mix with hot wine and swallow.
Xue Ji quotes Zhang Zhongjing: "When fire enters the Lung, it causes Fan (restlessness); when it enters the Kidney, it causes Zao (agitation)." The Heart belongs to Sovereign Fire. When Fire is excessive, it scorches Metal (Lung) and depletes Water (Kidney), leaving Fire alone. Thus, the combination of Lung and Kidney pathology manifests as Zao. *Liuren Shu* states: "If there is only heat and restlessness, it is Xu Fan (deficiency restlessness). Various deficiency-induced heat and restlessness resemble Shanghan (Cold Damage), but without aversion to cold and body ache, we know it is not Shanghan; without headache and tight pulse, we know it is not an interior excess syndrome. Do not use sweating or purging methods. Instead, administer Zhuye Tang; if accompanied by vomiting, administer Jupi Tang. Furthermore, Heart Qi deficiency leads to Fan first, followed by thirst, with slight fever and a floating, tight, and large pulse. 'Fan' refers to mental restlessness and internal heat, thus belonging to Yang syndromes. 'Zao' refers to physical agitation, or stripping naked to jump into a well, representing external false heat, thus belonging to Yin syndromes. External heat is rootless fire, hence it is deficiency. In children, distinguish between sitting/lying uneasily as 'Fan', and restless movement as 'Zao'. 'Fan' arises from Heat in the Heart Channel, causing spiritual confusion, mental fullness, and fright. 'Zao' arises from Wind in the Heart Channel, causing irritability and convulsions. For severe heat, use Huanglian Jiedu Tang; for mild cases, use Daochi San; for Wind-Heat, use Zhibao Dan; for rapid and forceful pulse with constipation and heat, use Shenxiong Wan. These are all treatments for Excess-Heat syndromes. If there is irritability with headache, shortness of breath, dry mouth and throat but no thirst, it is Deficiency; use Sijun Zi Tang plus Chuanxiong and Danggui. If thirst results from over-aggressive medication, use Zhuru Tang. If irritability prevents sleep, use Suanzaoren Tang. If the mind is disordered, with irritability and urge to vomit, use Zhusha Anshen Wan. If the face appears flushed like 'floating yang', eyes are red internally, and the six pulses are flooding but empty upon deep pressure, it is Zao caused by Blood Deficiency; use Danggui Buxue Tang. If there is agitation with nakedness and desire to enter a well, and the pulse is sinking and thin or floating and large but empty upon pressure, this is Zao caused by Yin Excess repelling Yang; use Shenfu Tang, which has the power to restore life."
Qingre Jiedu Wan treats accumulated heat in the Five Viscera, toxic qi attacking upward, causing chest oppression and irritability, sore throat and swelling, red and swollen eyes, heat in the head and face, dry lips and mouth, sores on the cheeks, spiritual confusion, palpitations and mental disturbance, and restlessness. It also treats summerheat toxicity causing red face and body heat, irritability with thirst, and inability to eat.
Ingredients: Hanshui Shi (Halloysitum Rubrum), Shigao (Gypsum Fibrosum) (each 8 liang), Qingdai (Indigo Naturalis) (4 liang).
Preparation and Administration: Grind into powder, mix evenly with Qingdai, and form pills using dough made from seven steamed buns mixed with water, sized like Euryale Seed. Take one pill after meals, dissolved in fresh cool water, or chewed finely and swallowed with Ginger Decoction. It is also suitable for various poisonings. For infantile convulsion with tidal fever, phlegm obstruction, chest irritability, red cheeks, excessive thirst, and instability in sitting/lying, take half a pill, adjusting the dose according to age and size.
Zhuru Tang (for vomiting)
Jupi Tang
Ingredients: Jupi (Citrus Reticulata Pericarpium, 1.5 liang), Gancao (Licorice Root, honey-fried), Zhuru (Bamboo Shavings, 0.5 liang each), Renshen (Ginseng Root, 2.5 qian).
Preparation and Administration: Take 5 qian per dose, decoct with ginger water, and take before meals.
Huanglian Jiedu Tang treats epidemic diseases where, after three days and resolution of sweating, there remains irritability, dry retching, dry mouth with groaning, fever, and inability to lie down.
Ingredients: Huanglian (Coptis Rhizome, stir-fried, 3 qian), Huangbai (Phellodendron Bark, stir-fried, 0.5 liang), Zhizi (Gardenia Fruit, stir-fried, 4 pieces), Huangqin (Scutellaria Root, stir-fried, 2 qian).
Preparation and Administration: Take 2–3 qian per dose, decoct in water. Repeat if ineffective. Also treats dysentery with heat.
Daochi San (Heart Channel)
Zhibao Dan treats various types of fright-epilepsy with Heart Heat, sudden attack by alien qi, irritability with wind-phlegm convulsions, delirious speech in Shanghan, and vomiting due to latent heat.
Ingredients: Sheng Xijiao (Rhino Horn, shaved), Sheng Daibao (Turtle Carapace and Plastron, shaved), Hupo (Amber), Zhusha (Cinnabar, water-ground), Xionghuang (Realgar, water-ground, each 1 liang), Jinbo (Gold Leaf, 50 pieces, half used for coating), Yinbo (Silver Leaf, 50 pieces), Pian Nao (Borneol, 1 spoon), Shexiang (Musk, 1 qian), Niuhuang (Calculus Bovis, 0.5 liang), Anxi Xiang (Styrax, 1.5 liang, ground, washed with wine to remove sand, taken 1 liang, decocted in wine to make a paste).
Preparation and Administration: Grind each ingredient separately into powder, mix evenly, add the Anxi Xiang paste. If too dry, add a little cooked honey. Form pills the size of Torreya Seeds. Take 1–2 pills per dose, dissolved in Renshen Decoction. Adjust dosage according to the child.
Shenxiong Wan treats stagnation of Wind-Heat, dizziness of head and eyes, sores in mouth and tongue, dental caries, generalized sores and scabies with teeth grinding, fright and palpitations, irritability with thirst, constipation, abdominal fullness due to accumulated heat, and infantile convulsions.
Ingredients: Dahuang (Rhubarb Radix et Rhizoma, raw), Huangqin (Scutellaria Root, each 2 liang), Sheng Qianniu Mo (Morning Glory Seed Powder, 1 liang), Huashi (Talcum, 4 liang), Huanglian (Coptis Rhizome), Bohe Ye (Mint Leaf), Chuanxiong (Sichuan Lovage Rhizome, each 0.5 liang).
Preparation and Administration: Grind into powder, bind with water paste, and form pills the size of Torreya Seeds. Take 3–4 pills per dose with warm water.
Suanzaoren Tang
Ingredients: Suanzaoren (Ziziphus Seed, shelled), Gancao (Licorice Root, honey-fried), Sheng Dihuang (Rehmannia Root, raw), Zhizi Ren (Gardenia Seed), Maidong (Ophiopogon Tuber), Renshen (Ginseng Root), Danggui Shen (Angelica Sinensis Radix, central part) (equal parts).
Preparation and Administration: Cut finely. Add Dengxin Cao (Juncus Medullary), add one zhan of water, decoct to 70%, strain, and take warm at any time.
Zhusha Anshen Wan (Heart) Danggui Buxue Tang (Deficiency Heat)